BLS Algorithm Flashcard 1
Rationale
A. Rationale: Utilize the AED once it is available. Successful CPR relies on immediate defibrillation when necessary. For example, in the case of ventricular fibrillation, shock success is higher early in its presentation. If left untreated, the fibrillatory waves decrease in size until the rhythm flat-lines into asystole. In this case, the AED must be connected to the patient, minimizing interruptions in chest compressions as much as possible.
Question
After performing 4 cycles of conventional CPR, the automated external defibrillator (AED) arrives. What is your next course of action?
a. Continue CPR while attaching the AED
b. Complete five cycles of conventional CPR first before attaching the AED
c. Have the paramedics perform defibrillation
d. An AED is not advisable at this point
Answer
a. Continue CPR while attaching the AED
Rationale
C. Rationale: Chest compressions are done using the two-finger technique if the patient is an infant. If there is more than 1 rescuer, then the two thumbs encircling technique is a better option. For older patients, the 1- or 2-hands technique is recommended.
Question
Which of the following is a chest compression technique for infants?
a. One hand chest compression technique
b. The two-handed chest compression technique
c. The two-finger chest compression technique
d. Chest thrust technique
Answer
c. The two-finger chest compression technique
Rationale
B. Rationale: After determining that the unconscious patient has a pulse and is breathing spontaneously, the rescuer must activate the emergency response system by dialing 9-1-1. Afterward, the rescuer can then monitor the patient by checking the pulse and respirations every 2 minutes until help arrives, adjusting the management when new signs or symptoms occur.
Question
A 7-year-old boy fell from a tree and hit his head, rendering him unconscious. You witnessed the fall. You find that he has a pulse and is breathing. What is your next course of action?
a. Stay with the patient and monitor him.
b. Activate the emergency response system.
c. Carry the patient and bring him to the nearest hospital.
d. Give a rescue breath every 2 to 3 seconds.
Answer
b. Activate the emergency response system.
Rationale
B. Rationale: Following the American Heart Association PALS Systematic Approach Algorithm, if you have decided that the patient is unresponsive and needs immediate intervention, then you should activate the emergency response system or shout for help. Then you should check for the patient’s breathing and pulse and support their airway, ventilation, and perfusion.
Question
After assessing that a 3-year-old girl is critically ill and unresponsive, what should be the next course of action?
a. Ensure scene safety
b. Activate the emergency response system
c. Check breathing and pulse
d. Support airway, ventilation, and perfusion
Answer
b. Activate the emergency response system
Rationale
D. Rationale: Following the pediatric BLS guidelines, a single rescuer may leave the scene to activate EMS and retrieve an AED if no one has witnessed the collapse or demise of the patient. If the event is witnessed, the rescuer should activate 911 prior to initiating CPR.
Question
After initially performing 2 minutes of conventional CPR, in which of the following situations can a single rescuer leave a patient to activate EMS or retrieve an AED?
a. A witnessed fall from a tree and the rescuer finds that the patient has no pulse and is not breathing
b. A witnessed collapse of a seriously ill child due to status asthmaticus
c. In all cases of pediatric cardiac arrest
d. An unconscious pediatric patient in unwitnessed cardiac arrest
Answer
d. An unconscious pediatric patient in unwitnessed cardiac arrest
Rationale
C. Rationale: The patient has progressed to cardiac arrest. In this instance, the pediatric cardiac life support algorithm should be followed. Activating the emergency response system is the most appropriate action in this situation.
Question
After providing 2 minutes of positive pressure ventilation via bag-mask for a 5-year-old girl in respiratory arrest, you no longer feel a pulse. What is your next course of action?
a. Begin high-quality CPR
b. Continue giving positive pressure ventilations
c. Activate the emergency response system
d. Check for airway obstruction by repositioning the patient, and check the bag-mask device
Answer
c. Activate the emergency response system
Rationale
C. Rationale: Conventional CPR is a must for resuscitation in infants and children because the most common cause of cardiac arrest is due to respiratory failure or shock. These medical conditions cause low oxygen saturation, making chest compression-only CPR inadequate.
Question
Compression-only CPR is better than no CPR at all, but what is the reason conventional CPR is best to perform in infants and children?
a. The most common cause of cardiac arrest in infants and children is primarily due to heart disease.
b. Trauma is the number one cause of cardiac arrest in infants and children.
c. Respiratory failure or shock are common medical conditions that cause cardiac arrest in children.
d. All of the above.
Answer
c. Respiratory failure or shock are common medical conditions that cause cardiac arrest in children.
Rationale
B. Rationale: In a witnessed collapse and the patient is not breathing and has no pulse, the rescuer leaves the patient to activate EMS, such as dialing 911. They should also obtain an AED and other emergency equipment for resuscitation. If someone else is present, the rescuer may ask them to get it for while tending to the patient.
Question
Determining the priorities for your actions is a fundamental skill that a rescuer must harness in each rescue attempt. What should you do when you witness a pediatric patient collapse and you have determined there is no pulse and the patient is not breathing?
a. Immediately start chest compressions
b. Leave the patient to call 911 and retrieve an AED
c. Await arrival of the paramedics
d. Give rescue breaths at a rate of 10 per minute and monitor the patient every 2 minutes
Answer
b. Leave the patient to call 911 and retrieve an AED
Rationale
B. Rationale: The correct chest compression-ventilation ratio for a two-person rescue team is 15:2. The 30:2 ratio is for single-rescuer CPR. Asynchronous ventilations, one breath every 2-3 seconds, is recommended if an advanced airway such as an endotracheal tube is in place during resuscitation.
Question
In the prehospital setting, what is the compression-ventilation ratio for a two-person rescue team when performing CPR on a child?
a. 30:2
b. 15:2
c. One breath every 5 seconds
d. One breath every 6 seconds
Answer
b. 15:2
Rationale
B. Rationale: The American Heart Association Pediatric Cardiac Arrest algorithm suggests that rescuers rotate every 2 minutes or 5 cycles of CPR to improve the quality of chest compressions and avoid rescuer fatigue.
Question
Studies show that high-quality CPR is compromised in the presence of rescuer fatigue. When there are two or more rescuers, how often should they rotate positions during CPR for pediatric cardiac arrest patients?
a. Every 1 minute
b. Every 2 minutes
c. Every 3 minutes
d. Every 4 minutes
Answer
b. Every 2 minutes